Profile Of Neonatal Admission At Chitwan Medical College

Abstract

In Nepal, three most common causes of newborn (NB) admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis and prematurity and they are the leading causes of death too. A study previously done in Nepal shows asphyxia as a leading cause of hospital admission accounting 22% followed by prematurity 20% and neonatal sepsis 17% with mortality due to these three causes being 7%, 3% and 5% respectively. Reasons of NICU admission in Chitwan Medical College (CMC) are clinical sepsis in 50% of cases followed by birth asphyxia 17.6%, and prematurity in 6.7% cases. Respiratory distress syndromes (RDS), neonatal jaundice, congenital hydrocephalus, meningitis are other reasons of NICU admission. Most of the babies were delivered by normal vaginal delivery at health facility 53%, and 47% of NB was delivered through lower section Caesarean section (LSCS). Only 6% of NB was having birth weight of less than 1.5 kg and majority of them were above that. There were 65% NB who was born at term and remaining 35% were preterm. Majority of NB were admitted within 72 hours of birth with 79% of the total admission. Hypoglycemia was observed in 83 out of 202 newborns accounting 41% neonatal hypoglycemia at birth. Journal of Chitwan Medical College 2013; 3(4); 13-16 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9547

Clinical Profile and Outcome of Neonates Admitted to the Neonatal Care Unit in a Rural Teaching Hospital

“…In a study done by Shakya A et al in KIST Medical College, Lalitpur, there was a male predominance with a male to female ratio of 1.4:1. 12 Similar pattern of male dominance was found in a study conducted by Shrestha SP et al in Chitwan Medical College and Teaching Hospital where they found male to female ration of 1.8:1. 13 Kanodia P et al also found male predominance in a study conducted in BP Koirala Institute of Health Sciences, Dharan, Nepal.…”

“…Similar finding was found in a study conducted by Shakya A et al where 89.2% were term and 10.8% preterm. 12 This finding was different from other centers where the percentages of premature babies were higher (23.8% to above 50%). [15][16][17] This is probably due to the fact that our hospital has only special baby care unit with no mechanical ventilators and so preterm babies are referred to higher center for further evaluation.…”

“…19 In a study conducted by Shakya A et al, the most common cause of neonatal admission was sepsis (45.9%), followed by respiratory conditions (14.7%), neonatal jaundice (12.5%), perinatal asphyxia (9.3 %) and prematurity/Small for gestational age (SGA) (6.5 %). 12 This is because neonatal sepsis may acquire during intrauterine period, during delivery time or after delivery at nursery itself. Prematurity was also an important reason for admission as suggested in our study.…”

Analysis of Neonatal Respiratory Distress in Neonatal Intensive Care Unit at Nepal Medical College

“…Previous studies from Nepal have reported incidence from 3.9% to 8.0%. 6 However, these studies have just been limited to an overview of the NICU admissions and the causes of the respiratory distress has not been discussed. In our study, we found the common causes of respiratory distress in neonates were MAS in 21.1% followed by septicemia in 16.5% out of which 33.3% were culture proven sepsis, TTN in 15.5%, pneumonia in 14.6%, birth asphyxia in 11.9%, hyaline membrane disease in 11.9%, and congenital heart disease in 6.4%.…”

“…The prevalence of respiratory distress varies with gestational age: 30.0% among preterm, 20.0% among post terms to 4.0% in term babies. Assuming prevalence of respiratory distress as 7.5% [6][7][8] and level of significance of 5.0 %, sample size was calculated using formula N= z 2 pq/d 2 where, p= prevalence of respiratory distress in newborns. q = 1-p, N= sample size, z=1.96, d= maximum tolerable error.…”